Cognitive performance is associated with return to work after ischemic stroke in young adults: The ODYSSEY study

被引:0
作者
Schellekens, Mijntje M., I [1 ]
Boot, Esther M. [1 ]
Verhoeven, Jamie, I [1 ]
Ekker, Merel S. [1 ]
Verburgt, Esmee [1 ]
Immens, Maikel H. M.
Mertens, Anne [1 ]
van Alebeek, Mayte E. [2 ]
Brouwers, Paul J. A. M.
Arntz, Renate M. [3 ]
van Dijk, Gert W. [4 ]
Gons, Rob A. R.
van Uden, Inge W. M.
den Heijer, Tom [5 ]
van Tuijl, Julia H. [6 ]
de Laat, Karlijn F. [7 ]
van Norden, Anouk G. W.
Vermeer, Sarah E. [8 ]
van Zagten, Marian S. G. [9 ]
van Oostenbrugge, Robert J. [10 ]
Wermer, Marieke J. H. [11 ,12 ]
Nederkoorn, Paul J. [13 ]
van Rooij, Frank G. [14 ]
van den Wijngaard, Ido R. [15 ]
de Kort, Paul L. M. [6 ]
de Leeuw, Frank-Erik [1 ]
Kessels, Roy P. C. [16 ,17 ,18 ,19 ]
Tuladhar, Anil M. [1 ]
机构
[1] Radboud Univ Nijmegen, Med Ctr, Dept Neurol, Donders Inst Brain Cognit & Behav, Nijmegen, Netherlands
[2] Gelre Hosp, Dept Neurol, Apeldoorn, Netherlands
[3] Med Spectrum Twente, Dept Neurol, Enschede, Netherlands
[4] Canisius Wilhelmina Hosp, Dept Neurol, Nijmegen, Netherlands
[5] Franciscus Gasthuis & Vlietland, Dept Neurol, Rotterdam, Netherlands
[6] Elisabeth Tweesteden Hosp, Dept Neurol, Tilburg, Netherlands
[7] Haga Hosp, Dept Neurol, The Hague, Netherlands
[8] Rijnstate Hosp, Dept Neurol, Arnhem, Netherlands
[9] Jeroen Bosch Hosp, Dept Neurol, Shertogenbosch, Netherlands
[10] Maastricht Univ, Sch Mental Hlth & Neurosci MHeNS, Dept Neurol, Med Ctr, Maastricht, Netherlands
[11] Leiden Univ, Med Ctr, Dept Neurol, Leiden, Netherlands
[12] Univ Med Ctr Groningen, Dept Neurol, Groningen, Netherlands
[13] Univ Amsterdam, Dept Neurol, Med Ctr, Amsterdam, Netherlands
[14] Med Ctr Leeuwarden, Dept Neurol, Leeuwarden, Netherlands
[15] Haaglanden Med Ctr, Dept Neurol, The Hague, Netherlands
[16] Radboud Univ Nijmegen, Donders Inst Brain Cognit & Behav, Ctr Cognit, Nijmegen, Netherlands
[17] Vincent van Gogh Inst Psychiat, Venray, Netherlands
[18] Radboud Univ Nijmegen, Med Ctr, Dept Med Psychol, Nijmegen, Netherlands
[19] Radboud Univ Nijmegen, Radboudumc Alzheimer Ctr, Med Ctr, Nijmegen, Netherlands
关键词
Cognitive impairment; stroke in young adults; neuropsychological tests; return to work; VALIDATION; SEVERITY; FATIGUE; AGE;
D O I
10.1177/23969873251324400
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Introduction: Limited data exist on cognitive performance and return to work after ischemic stroke, especially in patients under 50 years. We investigated whether cognitive performance in the subacute phase after ischemic stroke in young adults was associated with unemployment and the inability to retain their jobs among those who returned to work. Patients and methods: We conducted a multicenter prospective cohort study between 2013 and 2021, enrolling patients aged 18-49 years with first-ever ischemic stroke. Cognitive assessments were performed within 6 months following the index event, covering seven cognitive domains. We categorized patients with cognitive impairment (Z-score < -1.5 on a domain) and as no/mild or major vascular cognitive disorder (VCD; Z-score < -2.0 in one or more domains). Cognitive performance and other predefined characteristics were chosen to identify factors associated with unemployment and, among patients who returned to work, the inability to maintain employment. Results: Of 525 patients (median age 44.3 [IQR 38.0-47.4] years; 243 women [46.3%]); median follow-up of 6.6 [IQR 4.5-8.2] years), 426 patients (81.1%) returned to work. Sixty-five patients (15.3%) were unable to maintain employment. In multivariable logistic regression analysis, major VCD (OR = 2.0; 95% CI 1.3-3.0; p = 0.002) and cognitive impairment in processing speed (OR = 2.0; 95% CI 1.3-3.3; p = 0.004) were associated with unemployment, but not with the inability to maintain employment. Discussion and conclusion: In young patients after a first-ever ischemic stroke, major VCD and impaired processing speed in the subacute phase after stroke were independently associated with unemployment, but not with the inability to maintain employment.
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页数:12
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